title: Impact of octreotide long-acting release on tumour growth control as a first-line treatment in neuroendocrine tumours of pancreatic origin.
abstract: BACKGROUND
  Somatostatin analogues (SSA) are widely used in the treatment of patients with functioning and non-functioning neuroendocrine tumours (NET). The aim of our investigation was to evaluate the antiproliferative effect of SSA in patients with pancreatic NET.
  
  
  METHODS
  We retrospectively analysed records of 43 patients with pancreatic NET treated at our clinic with octreotide long-lasting release as a first-line therapy. The aim of our study was to investigate the overall best response according to the RECIST criteria, overall best response defined as disease control rate (SD+PR), response and disease control rate at 12 months, and time to tumour progression (TTP).
  
  
  RESULTS
  The mean age (± SD) of the patients (16 female/27 male) at initial diagnosis was 54.7 ± 11.86 years. At the start of therapy, 39 of 43 patients were classified as stage IV according to ENETS-TNM. Tumours were graded, based on MiB-1/Ki67 staining, as G1 (n = 8), G2 (n = 30) or unknown (n = 5). The octreoscan was positive in 37 patients, negative in 2 and unknown in 4 cases. Nineteen patients had functioning tumours, 24 patients had non-functioning tumours. Median overall survival was 98 months, and median TTP was 13 months. Analysis of grading showed a statistically significant influence on TTP when comparing the median TTP for Ki67 >10% with Ki67 <5% (p = 0.009) and Ki67 5-10% (p = 0.036).
  
  
  CONCLUSIONS
  SSA may be considered as a first-line treatment for antiproliferative purposes in metastatic NET of the pancreas. Patients with a proliferation index <10% displayed a more durable response compared to those with a higher proliferation index.
authors.affiliation: Department of Hepatology and Gastroenterology, Charité, Berlin, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Jann
authors.forename: T
authors.initials: T
authors.lastname: Denecke
authors.forename: M
authors.initials: M
authors.lastname: Koch
authors.forename: U F
authors.initials: UF
authors.lastname: Pape
authors.forename: B
authors.initials: B
authors.lastname: Wiedenmann
authors.forename: M
authors.initials: M
authors.lastname: Pavel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology*; D049109:Cell Proliferation / Q000187:drug effects*; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018358:Neuroendocrine Tumors / Q000188:drug therapy / Q000473:pathology*; D015282:Octreotide / Q000494:pharmacology*; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology*; D012189:Retrospective Studies
chemical_list: D018931:Antineoplastic Agents, Hormonal; D003692:Delayed-Action Preparations; D015282:Octreotide